JP5687891B2 - Auxiliary device for gastric wall fixation device - Google Patents

Description

  The present invention relates to an auxiliary tool used for a gastric wall fixing tool that fixes an organ such as a stomach of a patient to a skin side wall portion.

  Conventionally, as a stomach wall fixing tool used to fix an organ such as a stomach to a skin side wall in a patient's body, a rod-shaped locking member installed on the inner wall side of the patient's organ, and a substantially center of the locking member And a suture thread which penetrates the inner wall of the patient's organ and the outside of the body, and the suture thread is fixed to a predetermined length outside the patient's body. What has the fixing member which can do is known (for example, refer patent document 1).

  The locking member of the gastric wall fixture is installed in the patient's body by using a gastric wall fixture puncture needle having a hollow needle body that can accommodate the locking member at the tip.

  Specifically, first, the operator stores the locking member at the distal end of the outer needle, and in that state, punctures a predetermined portion of the patient with the gastric wall fixing tool puncture needle, and connects the inner wall of the patient's organ to the outside of the body. The locking member is then placed in the patient's body by pushing the locking member out of the needle body.

  Further, the gastric wall fixing device fixes the organ to the abdominal wall by pulling the suture thread outside the patient's body, and the locking member is engaged with the inner wall of the organ. In this state, the suture thread is fixed by the fixing member. be able to.

JP-A-4-226676

  However, since the hole at the tip of the needle body is small and the locking member is also a small part, when the operator stores the locking member at the tip of the needle body, the tip of the needle body makes a mistake. May cause it.

  An object of this invention is to provide the auxiliary tool for gastric wall fixing tools which eliminates this inconvenience and can prevent a piercing.

In order to achieve such an object, the assisting device for gastric wall fixing device of the present invention comprises a gastric wall fixing device comprising a suture thread having a rod-shaped locking member coupled to the tip in a T shape, and the locking member at the tip. A gastric wall fixing tool assisting device used for a gastric wall fixing tool puncture needle having a hollow needle body having a storing portion that can be stored, and a cylindrical portion that covers the distal end of the needle main body, and the cylindrical shape includes a guide hole communicating with the housing portion of the open needle body to the distal end portion of the part, and a slit extending through the outer wall of the guide hole and the cylindrical portion over the entire axial direction, the cylindrical portion By inserting the tip of the needle body from the rear end portion of the needle body, with the tubular portion mounted so as to cover the tip of the needle body, from the guide hole provided in the tip portion of the cylindrical portion The locking member is inserted and the locking member is stored in the storage portion, and the suture is pulled backward through the slit. It is possible, characterized in that it is possible to separate the cylindrical portion from 該胃 wall fixture puncture needle while wearing the locking member to the needle body.

  The assisting device for gastric wall fixing tool of the present invention is cylindrical and is attached to the needle body in a state of covering the distal end of the needle body of the gastric wall fixing tool puncture needle. Moreover, in this state, the assisting device for gastric wall fixing tool can insert the locking member through the guide hole. The inserted locking member is inserted into the tip of the needle main body while being guided along the guide hole, and is further pushed to be stored in the storage portion of the needle main body. Then, the suture thread coupled to the locking member can be pulled from the front end in the axial direction toward the rear end via the slit provided on the side surface of the cylindrical portion. The slit penetrates the guide hole and the outer wall of the cylindrical portion over the entire axial direction. Therefore, when the tubular part is detached from the puncture needle with the locking member attached to the puncture needle, the suture does not get caught by the tubular part because it passes between the slits.

  As a result, the assisting device for the gastric wall fixing tool of the present invention can store the locking member of the gastric wall fixing tool in the storage portion in a state where the distal end of the needle main body is covered. It is possible to prevent erroneous piercing when attaching to the.

In the gastric wall fixing tool assisting device of the present invention, the gastric wall fixing tool puncture needle includes a rod-shaped needle base connected to a rear end of the needle body, and the gastric wall fixing tool auxiliary tool holds the needle base. it is preferable to provide a hub holder that, a needle holder having a groove for accommodating the needle body as well as connecting the tubular portion and the needle group holding unit.

  According to the gastric wall fixture assisting device having this configuration, the tip of the needle body is brought into contact with the groove of the needle holding portion, and the tip of the needle body is slid in this direction toward the cylindrical portion from this state. Can be attached to the guide hole of the cylindrical portion.

  As a result, the assisting device for the gastric wall fixture having this configuration can prevent false puncture by the needle body even when attached to the puncture needle of the gastric wall fixture.

  Furthermore, according to the gastric wall fixture assisting device having this configuration, the needle base of the gastric wall fixture puncture needle is held by the needle base holding portion with the tip of the needle body mounted in the guide hole of the cylindrical portion. Can do.

  As a result, the gastric wall fixture assisting device having this configuration can be handled in a state where the tip of the needle body is covered, so that erroneous puncture can be prevented.

The top view which shows the auxiliary tool for gastric wall fixing tools of this embodiment. The top view which shows a gastric wall fixing tool puncture needle. The top view which shows a stomach wall fixing tool. Explanatory drawing which shows the state which attaches a stomach wall fixing tool puncture needle to the auxiliary tool for gastric wall fixing tools of this embodiment. The top view which shows the gastric wall fixing tool auxiliary tool which attached the gastric wall fixing tool puncture needle. Explanatory drawing which shows the state which attaches a stomach wall fixing tool to a gastric wall fixing tool puncture needle.

  As shown in FIG. 1, the assisting device 1 for gastric wall fixing tool of the present embodiment is made of synthetic resin and is integrally molded, and includes a cylindrical portion 2, a needle base holding portion 3, and a needle holding portion 4 that connects them. It has.

  The cylindrical portion 2 is a hollow cylindrical member that is mounted so as to cover the tip of an outer needle 11 (needle body), which will be described later, and includes a guide hole 5 that communicates with the storage portion 15 of the outer needle 11 at the tip. Yes. The outer wall of the cylindrical portion 2 has a slit 6 that penetrates over the entire axial direction. The needle holding part 4 is a rod-like member connected to the cylindrical part 2 and has a groove part 7 for storing the outer needle. The needle base holding part 3 is a plate-like member connected to the needle holding part 4 and has a claw part 8 for holding a needle base 12 of a stomach wall fixing tool puncture needle 10 to be described later.

  As shown in FIG. 2, the gastric wall fixing tool puncture needle 10 includes a hollow outer needle 11, a rod-shaped needle base 12 connected to the outer needle 11, and a plate-like suture fixing plate installed therebetween. 13 and an undercase 14 connected to the needle base 12.

  The outer needle 11 has a storage portion 15 that can store a locking member 22 described later in the inner space at the tip, and the inner needle 16 is inserted in the other inner space. The rear end of the inner needle 16 is connected to a lever 17 provided on the needle base 12, and the inner needle 16 moves back and forth inside the outer needle 11 by operating the lever 17 back and forth in the axial direction. At the same time, a locking member 22 described later stored in the storage portion 15 can be pushed out from the internal space.

  The suture thread fixing plate 13 is provided with a sandwiching portion 18 that penetrates the side surface of the plate-like member from the front to the back, and can be fixed by sandwiching a suture thread 21 described later.

  The undercase 14 has a rod shape so that it can be easily gripped, and is close to the lever 17 provided on the needle base 12, so that the lever 17 can be easily operated by a hand holding the undercase 14 as it is. can do.

  As shown in FIG. 3, the stomach wall fixing device 20 includes a suture thread 21, a rod-shaped locking member 22 coupled to the distal end of the suture thread 21 in a T shape, and a fixation coupled to the rear end of the suture thread 21. And a member 23. The fixing member 23 is plate-shaped and penetrates the front and back surfaces with a suture thread. Therefore, by sliding the fixing member 23, the length of the suture 21 between the locking member 22 and the fixing member 23 can be adjusted when the organ is fixed to the abdominal wall.

  Next, the usage method of the auxiliary tool 1 for gastric wall fixing tools of this embodiment is demonstrated.

  First, a method for attaching the gastric wall fixing tool puncture needle 10 to the gastric wall fixing tool auxiliary tool 1 will be described.

  As shown in FIG. 4A, first, the operator brings the distal end of the outer needle 11 of the stomach wall fixing tool puncture needle 10 into contact with the groove portion 7 of the needle holding portion 4.

  Next, as shown in FIG. 4B, the surgeon slides the distal end of the outer needle 11 in the direction of the cylindrical portion 2 from the contacted state.

  As a result, as shown in FIG. 4C, the cylindrical portion 2 is mounted so as to cover the tip of the outer needle 11. Further, by bringing the stomach wall fixing tool puncture needle 10 closer to the gastric wall fixing tool auxiliary tool 1 from this state, the needle base 12 is held by the claw portion 8 as shown in FIG.

  Therefore, the gastric wall fixing tool auxiliary tool 1 can be attached with the gastric wall fixing tool puncture needle 10 without being erroneously pierced by the outer needle 11. Further, the attached gastric wall fixing tool puncture needle 10 has the cylindrical portion 2 covering the distal end of the outer needle 11, the needle holding portion 4 covering the entire outer needle 11, and the nail portion 8 covering the needle base 12. Is fixed, so that it is possible to prevent erroneous piercing by the outer needle 11 even during handling other than during surgery.

  Secondly, a method of attaching the gastric wall fixture 20 to the gastric wall fixture puncture needle 10 via the gastric wall fixture auxiliary tool 1 will be described.

  As shown in FIG. 6A, first, the operator inserts the locking member 22 into the guide hole 5 in a state where the gastric wall fixing tool puncture needle 10 is attached to the gastric wall fixing tool auxiliary tool 1. As a result, the pushed distal end of the locking member 22 is guided from the guide hole 5 along the inner wall of the tubular portion 2 to the storage portion 15 at the distal end of the outer needle 11.

  Next, the surgeon pulls the suture 21 in the proximal direction of the needle. As a result, as shown in FIG. 6B, the locking member 22 coupled to the distal end of the suture 21 is also pulled in the direction of the needle base 12, and the locking member 22 is pulled to the distal end of the outer needle 11. From the state where a part is inserted, the state is completely inserted into the storage portion 15 of the outer needle 11.

  The surgeon can pinch the pulled suture 21 into the holding portion 18 of the suture fixing plate 13 with the tension applied as it is.

  Furthermore, the surgeon can remove the gastric wall fixing tool auxiliary tool 1 from the gastric wall fixing tool puncture needle 10 by performing a procedure opposite to the attachment. Since the opening direction of the slit 6 and the groove portion 7 is the same in the gastric wall fixing tool auxiliary tool 1, a gap is formed through the inner wall and the outer wall in the entire axial direction. Even when the gastric wall fixing tool assisting tool 1 is removed with the locking member 22 attached to the needle 10, the suture thread 21 does not get caught in the tubular portion 2 because it passes through the gap.

  As a result, the gastric wall fixing tool auxiliary tool 1 can attach the gastric wall fixing tool 20 to the gastric wall fixing tool puncture needle 10 in a state where the outer needle 11 is entirely covered. can do.

  Since the suture thread 21 is fixed to the holding portion 18, it is not necessary to hold the suture thread 21 by hand when puncturing a predetermined portion of the patient. Further, since the suture thread 21 is linearly stretched in the same direction as the puncturing direction, the resistance when puncturing is reduced compared to the case of wrapping around the outer needle 11 and the burden on the patient is reduced. Can be reduced.

  DESCRIPTION OF SYMBOLS 1 ... Auxiliary tool for gastric wall fixing tools, 2 ... Cylindrical part, 5 ... Guide hole, 6 ... Slit, 10 ... Gastric wall fixing tool puncture needle, 11 ... Needle main body, 15 ... Storage part, 20 ... Gastric wall fixing tool, 21 ... Suture, 22 ... Locking member.

Claims (2)

A gastric wall fixing tool comprising a suture threaded with a rod-shaped locking member at the tip thereof in a T-shape;
A gastric wall fixing tool auxiliary tool used for a gastric wall fixing tool puncture needle comprising a hollow needle body having a storage portion capable of storing the locking member at the tip,
A cylindrical part to be mounted over the tip of the needle body;
A guide hole that opens at the distal end of the cylindrical portion and communicates with the storage portion of the needle body;
Having a slit that penetrates the guide hole and the outer wall of the cylindrical portion over the entire axial direction;
By inserting the tip of the needle main body from the rear end of the cylindrical portion, the cylindrical portion is provided at the tip of the cylindrical portion so as to cover the tip of the needle main body. The locking member is inserted through the guide hole to store the locking member in the storage portion, and the suture can be pulled backward through the slit. The locking member is attached to the needle body. An assisting device for a gastric wall fixing tool, wherein the tubular part can be detached from the puncture needle of the gastric wall fixing tool in a mounted state. The gastric wall fixture puncture needle comprises a rod-like needle base connected to the rear end of the needle body ,
The gastric wall fixture auxiliary tool is:
A needle base holding portion for holding the needle base ;
The cylindrical portion and the needle stomach wall fixture for aid according to claim 1, further comprising a needle holder having a groove for accommodating the needle body as well as connecting the group holding section.

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